SOUTHEASTERN PHARMACY LLC (NPI# 1811540867) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811540867 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN PHARMACY LLC |
| Practice Address |
5711 Altama Ave Ste G Brunswick GA 31525-2200 |
| Practice Telephone | 9122642622 |
| Practice Fax Number | 9122641392 |
| Mailing Telephone | 9122642622 |
| Mailing Fax Number | 9122641392 |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |
| Authorized Official Name | GEORGE MICHAEL LEWIS (OWNER/PIC) |
| Authorized Official Telephone | 9122642622 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| ALTAMA PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336165547 | Southeastern Pharmacy LLC | Pharmacy | 5711 Altama Ave, Unit G, Brunswick, GA 31525-2240 | 2006-07-14 |
| Street Address |
5711 ALTAMA AVE STE G |
| City | BRUNSWICK |
| State | GA |
| Zip Code | 31525-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063905990 | Jonathon Wesley Capps | Physician Assistant | 1111 Glynco Pkwy Bldg 1, Ste 10, Brunswick, GA 31525 | 2018-06-14 |
| 1366993628 | Hands Down Muscle Restoration, Inc | Homeopath | 1212 Chapel Crossing Road, Brunswick, GA 31525 | 2016-10-20 |
| 1619424173 | Jebediah S Christy Dds - Brunswick Pllc | Dentist | 11455 Canal Crossing, Brunswick, GA 31525 | 2016-09-01 |
| 1831545508 | Heller Family Medicine, LLC | General Practice | 208 Scranton Connector Ste 120, Brunswick, GA 31525 | 2016-05-11 |
| 1437525391 | Natisha Danielle Hill | Occupational Therapy Assistant | 138 Wingefield Commons Drive, Brunswick, GA 31525 | 2015-08-14 |
| 1811269632 | Solar Family Practice | Family Medicine | 122 Scranton Connector, Suite 112, Brunswick, GA 31525 | 2012-02-09 |
| 1700187895 | Chetan Patel | Pharmacist | 12 Woodfall Ct, Brunswick, GA 31525 | 2010-11-05 |
| 1194914275 | Dialysis of Golden Isles, LLC | Clinic/Center | 475 Gateway Center Blvd, Brunswick, GA 31525 | 2007-10-15 |
| 1902939325 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Frazier Street, Brunswick, GA 31525 | 2007-03-14 |
| 1609909498 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 115 Frazier Road, Brunswick, GA 31525 | 2007-03-13 |
| Find all providers in zip 31525 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134214943 | Gateway Behavioral Health Services | Pharmacy | 600 Coastal Village Drive, Room 107, Brunswick, GA 31520 | 2006-10-04 |
| 1053326975 | Riser Foods Company | Pharmacy | 3440 Center Rd, Brunswick, OH 44212-3689 | 2006-07-29 |
| 1922031582 | Brunswick Medical Center Pharmacy At Parkview | Pharmacy | 329 Maine St Ste E, Brunswick, ME 04011-3310 | 2006-07-08 |
| 1831121870 | Freds Stores of Tennessee Inc | Pharmacy | 5485 New Jesup Hwy, Brunswick, GA 31523-1119 | 2006-07-07 |
| 1922043843 | Discount Drug Mart Inc | Pharmacy | 1673 Pearl Rd, Brunswick, OH 44212-3405 | 2006-06-17 |
| 1588191373 | Rite Aid Corp | Pharmacy | 3871 Center Rd, Brunswick, OH 44212-3058 | 2017-05-11 |
| 1033563077 | Donato Health LLC | Pharmacy | 3010 Altama Ave, Brunswick, GA 31520-4607 | 2016-04-15 |
| 1093982886 | Pharmacare of Georgia Inc | Pharmacy | 4319 New Jesup Hwy, Brunswick, GA 31520-1605 | 2008-05-12 |
| 1568524171 | Medicine Plus Brunswick | Pharmacy | 610 9th Ave, Brunswick, MD 21716-1828 | 2006-12-14 |
| 1497867337 | The Medicine Cabinet of Brunswick, LLC | Pharmacy | 2500 Starling St, Ste 102, Brunswick, GA 31520-4265 | 2006-08-31 |
| Find all providers in BRUNSWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.